Managing demand for urgent care is one of the greatest challenges facing the NHS. People travel to A&E departments when they don’t need to. As a result, emergency services are put under unnecessary strain – wasting scarce NHS resources.
This project was shaped by one of the largest research projects in this area, undertaken by Verve and based on depth-interviews with patients (within 24 hours of their visit to Wexham Park A&E), GPs and a survey of 3,000 residents.
Most people do the right thing when they have the information they need – so materials contained comprehensive and detailed local information (e.g. conditions, addresses, opening hours).
Working with trusted GPs to ‘front’ local campaigns supported by work within the practice, particularly receptionists and first points of contact.
Materials distributed via local health and care professionals, community-level networks and local organisations (e.g. schools) as well as door-to-door.
Evaluation was through direct measurement of attendance at A&E and walk-in services compared with control population(s) and the campaign made a measurable impact on urgent care demand.
Overall, attendances by Ringmead patients across both A&E and walk-in services fell compared with an aggregate control population in East Berkshire. For Ringmead patients (15,700 list) we can estimate total savings across urgent care services of around £37,000.
Overall, attendances by targeted patients across both A&E and walk-in services fell compared with an aggregate control population in East Berkshire. The data suggests this is a sustained reduction.
A localised, bespoke campaign can have a more measurable impact than large national campaigns. This data also suggests that direct communication with patients presents a longer lasting real effect on how the public manages their own care.
Long term benefits
The campaign had a long-term benefit – with no bounce back. We estimate that over 11 months there were around 230 (7%) fewer A&E visits and around 300 (10%) fewer walk-in attendances.
Within the mix of attendances, the “substitution” of using walk-in rather than A&E was particularly pronounced for target patients compared with the control. We might hypothesise that this means patients are making better choices. The core of our local interventions was distribution of specific, localised information about which services to access under which circumstances.